I have just started in a career that will last over 40 years and I want to know I am making the best choices for me

I would like to spend more time with my family and do work I find satisfying

I do not get on with my partners - I think I need a change of location/ practice

I have not worked for five years - how and where to start getting back

My health has given some severe restrictions to working but I am still ambitious

I want to start a portfolio career but don't know what to add in

I don't know what I want from my career but my family keep pushing me to decide

I am definitely at a crossroads but I can't see the way

I have been forced into medical early retirement but I still have a brain and want to use it

I want to work with the disabled but my current role does not allow that

I'd like to spend some time abroad but I am worried I might not get a job on my return

I enjoy my work but I often feel that I have some talents that are not used and I'd like to use them

I don't feel I have yet found my "niche" and I keep changing route in order to find it.. tiring!!

As you can see from this small number of comments - career support is not always sought because radical change is wanted. It can be just as relevant for exploring potential in a current role or returning to work that one did before after time away from work. Thus career change is a much much broader term than most people use it for. It can refer to anything that makes a current career better. Changing attitude, changing location, changing hours - are all elements of career change.

Many times a medic will say they want a major career change when in fact what they really want is to find a way of working that enables them to gain satisfaction and feel they are making a difference. This may at times be achieved without a radical leap.

Are you procrastinating about anything? The chances are that you are. We all do itI have a small pile of rotting vegetables near my back door that needs to go onto the compost heap - yet I put off doing it ( psychoanalyse that one if you dare!) and I am not entirely sure why.

This particular procrastination doesn’t have any immediately severe consequences ( mild odour when open back door - possibly of attracting rats or other animals perhaps) . However when procrastination is applied to some areas of life - there are major consequences.

I recently saw a doctor who had never enjoyed medicineFrom joining as a medical student to a recent resignation from GP registrar training.Representing over ten years of not feeling on the right trackNot having a sense of working towards something that was inspiringFeeling as if the career was a complete treadmill and / or a ball and chainTrying to do as little as possible and scraping byWith the resultant low performance, low self esteem, low mood and lost confidence that goes with the above cycle.

All this in the face of a bright and talented person underneath the mask and cloud of disillusionment. Awareness of these issues had festered beneath the surface for years and a sense of guilt for “not fitting in “ also pervaded.

The default approach that emerged over the years - one that was on retrospect dysfunctional yet also understandable - was one of chronic and very resistant procrastination. Put off dealing with it.

This is an extreme example of course but it demonstrates what invariably happens if a person does not feel well matched in their career and then takes no action.

One has to ask why this doctor did not take action sooner?The answer to that question is surprisingly complex and I could write several articles on the reasons why doctors don’t address their career concerns . The deep reasons behind each person’s procrastination are different.

The main point I'd like to get across is that procrastination about ones career can be overcome. It is not a quick fix mind! But there are ways of encouraging a person to limit or even cease procrastination.

If you needed to change where or how you work - tomorrow - do you know what you would do?

I have long thought that medics need a plan B career and possibly a plan Z

There are lots of risks to being a medicNeedlestick injuriesBurnoutBoredomSome medics do get made redundant - it is rare but it happenshttps://www.bma.org.uk/advice/employment/redundancy/redundancy-guide

Most people only think about the career back up plan AFTER something has happened to force their hand but at this point the time and resources to put into steady well planned career diversification may not be at hand. Career planning under pressure is nowhere near as easy or as fun or as effective as career planning done at a steady unhurried pace.

Medical career planning is something that at Medical Forum we encourage ALL THE TIMEI don't meant 24/7 but certainly between 1 and 4 hours a week ( former - maintenance level and latter when things need to crank up a bit)

There is a tendency to assume that one's employer is responsible for ones careerThe truth is - you are the person with the most vested interest in your career your finances and your future.

For some people career planning comes naturally but for others it is an area of mystery or even strikes fear into the heart.However for everyone - a slow steady approach to career planning ( over years) is the most effective way of gaining back up plans or steering diversity and change and new challenges into ones career. Zero career planning on the other hand - the more passive approach to ones career - can lead one into career plateau, career spirals ( downwards) and career crises or an unsatisfying sense of career drift.

People often state that they don't have time for career planning - busy weeks and all.I ask two questionsA Would you feel more secure with a back up career plan?B Do you spend any time each week moaning about or feeling deenergised by your career?

​If the answer to both of these is yes - then merely shifting the time spent in B into time spent in A will most likely mean that career planning can be time neutral.